NPI | 1821567686 |
---|---|
Former Name | RANDI ALEXIS TRENT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024178868) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 24394) |
Enumeration Date | 2018-11-21 |
Last Update Date | 2024-05-14 |